Biomedical subjects

Dwight G Nishimura

Publications and source records attributed to Dwight G Nishimura.

32 records · Page 2Linked to original sources

PubMed2004

Dynamic real-time architecture in magnetic resonance coronary angiography--a prospective clinical trial.

OBJECTIVES: A dynamic real-time (dRT) architecture has been developed to address limitations in magnetic resonance coronary angiography (MRCA). A prospective clinical trial of 45 patients suspected of coronary artery disease was conducted to determine clinical utility of this integrated real-time system. BACKGROUND: Clinical implementation of MRCA is not performed routinely today. However, improved anatomic coverage, image quality, and scan flexibility may enhance its clinical utility. A novel real-time architecture addresses these challenges through instantaneous reconfiguration between real-time (RT) and high-resolution (HR) imaging sequences with dynamic selection of the desired element on a custom-designed receiver coil. METHODS: A total of 45 subjects were recruited consecutively to evaluate scan time, anatomic coverage, image quality, and detection of coronary lesions. Using a modern PC, the dRT switches from RT to gated HR imaging sequence in one repetition time (39 ms). Magnetic resonance imaging (MRI) scanning was performed using a custom-designed coronary coil consisting of two four-inch phase-array circular elements enabled with real-time selection of the desired coil element. RESULTS: All studies were completed in less than 45 minutes and required a mean of 12 breath holds (16 heartbeats). Of the total number of coronary segments, 91% (357/394) were visualized. Excellent or good image quality was achieved in 86% of the segments. Blinded analysis of the coronary arteries revealed sensitivity of 93% and specificity of 88% in the detection of coronary stenoses. CONCLUSIONS: The integrated environment of dRT provides a rapid and flexible scan protocol for MRCA while achieving wide anatomical coverage, high image quality, and reliable detection of coronary stenosis in short scan time.

Adult↗

PubMed2003

Spiral magnetic resonance coronary angiography with rapid real-time localization.

A spiral high-resolution coronary artery imaging sequence (SH) interfaced with real-time localization system (RT) has been developed. A clinical study of 40 patients suspected of coronary artery disease (CAD) was conducted. Segmented k-space acquisition techniques have dominated magnetic resonance coronary angiography (MRCA) over the last decade. Although a recent multicenter trial using this technique demonstrated encouraging results, the technique was hampered by low specificity. Spiral k-space acquisition had demonstrated several advantages for MRCA. Therefore, a first clinical trial implementing spiral high-resolution coronary imaging sequence with real-time localization (SH-RT) was performed.A clinical study of 40 patients suspected of CAD undergoing X-ray angiography was conducted to analyze the clinical reliability of this novel imaging system. The SH-RT had been designed to exploit the unique capability of two imaging sequences. The RT allowed a rapid localization of the coronary arteries. Then SH achieved multislice acquisition during a short breath-hold with submillimeter resolution. The MRCA data were analyzed for scan time, anatomic coverage, image quality, and accuracy in detecting CAD. In 40 subjects, SH achieved 0.7 to 0.9 mm resolution with 14-heartbeat breath-holds. Excellent or good image quality was achieved in 78% (263/337) of the coronary segments. Blinded consensus reading among three observers generated sensitivity of 76% and specificity of 91% in the detection of CAD compared with X-ray angiography. The MRCA imaging sequence implementing a novel spiral k-space acquisition technique enabled rapid and reliable imaging of the CAD in submillimeter resolution with short breath-holds.

Adult↗

PubMed2003

Real-time imaging of skeletal muscle velocity.

PURPOSE: To test the feasibility of using real-time phase contrast (PC) magnetic resonance imaging (MRI) to track velocities (1-20 cm/second) of skeletal muscle motion. MATERIALS AND METHODS: To do this we modified a fast real-time spiral PC pulse sequence to accommodate through-plane velocity encoding in the range of -20 to +20 cm/second. We successfully imaged motion of the biceps brachii and triceps brachii muscles during elbow flexion and extension in seven unimpaired adult subjects using real-time PC MRI. RESULTS: The velocity data demonstrate that the biceps brachii and the triceps brachii, antagonistic muscles, move in opposite directions during elbow flexion and extension with velocity values in the muscle tissue ranging from -10 to +10 cm/second. CONCLUSION: With further development, real-time PC MRI may provide a means to analyze muscle function in individuals with neurologic or movement disorders who cannot actively complete the repeated motions required for dynamic MRI techniques, such as cine PC MRI, that are more commonly used in musculoskeletal biomechanics applications.

Adult↗

PubMed2003

Rapid measurement of time-averaged blood flow using ungated spiral phase-contrast.

A novel ungated spiral phase-contrast (USPC) imaging method was developed for rapid measurement of time-averaged blood-flow rates in the presence of pulsatility. The spatial point-spread function was analyzed to provide an intuitive understanding of how spiral trajectories, which sample the k-space origin at every excitation, can mitigate the effects of pulsatility. Pulsatile flow phantom experiments were performed to validate the accuracy and repeatability of the USPC method. The measurement of flow in the renal and femoral arteries of normal volunteers were also performed. The phantom results (error < or = +9%, SD(phantom) < or = 2%, time-averaged pulsatile-flow rates = 3-15 ml/s) and in vivo results (SD(renal) < or = 8%, SD(femoral) < or = 14%) demonstrate the potential of the USPC method for rapidly and repeatedly measuring accurate time-averaged blood flow even in relatively small arteries and in the presence of strong pulsatility.

Blood Flow Velocity↗

PubMed2003

Comparison of new sequences for high-resolution cartilage imaging.

The high prevalence of osteoarthritis continues to demand improved accuracy in detecting cartilage injury and monitoring its response to different treatments. MRI is the most accurate noninvasive method of diagnosing cartilage lesions. However, MR imaging of cartilage is limited by scan time, signal-to-noise ratio (SNR), and image contrast. Recently, there has been renewed interest in SNR-efficient imaging sequences for imaging cartilage, including various forms of steady-state free-precession as well as driven-equilibrium imaging. This work compares several of these sequences with existing methods, both theoretically and in normal volunteers. Results show that the new steady-state methods increase SNR-efficiency by as much as 30% and improve cartilage-synovial fluid contrast by a factor of three. Additionally, these methods markedly decrease minimum scan times, while providing 3D coverage without the characteristic blurring seen in fast spin-echo images.

Cartilage↗

PubMed2003

Fat-suppressed steady-state free precession imaging using phase detection.

Fully refocused steady-state free precession (SSFP) is a rapid, efficient imaging sequence that can provide diagnostically useful image contrast. In SSFP, the signal is refocused midway between excitation pulses, much like in a spin-echo experiment. However, in SSFP, the phase of the refocused spins alternates for each resonant frequency interval equal to the reciprocal of the sequence repetition time (TR). Appropriate selection of the TR results in a 180 degrees phase difference between lipid and water signals. This phase difference can be used for fat-water separation in SSFP without any increase in scan time. The technique is shown to produce excellent non-contrast-enhanced, flow-independent angiograms of the peripheral vasculature.

Adipose Tissue↗

PubMed2003

Rapid quantitation of high-speed flow jets.

Flow jets containing velocities up to 5-7 m/s are common in patients with congenital defects and patients with valvular disease (stenosis and regurgitation). The quantitation of peak velocity and flow volume in these jets is clinically significant but requires specialized imaging sequences. Conventional 2DFT phase contrast sequences require lengthy acquisitions on the order of several minutes. Conventional spiral phase contrast sequences are faster, but are highly corrupted by flow artifacts at these high velocities due to phase dispersion and motion during the excitation and readout. A new prospectively gated method based on spiral phase contrast is presented, which has a sufficiently short measurement interval (<4 ms) to minimize flow artifacts, while achieving high spatial resolution (2 x 2 x 4 mm(3)) to minimize partial volume effects, all within a single breathhold. A complete single-slice phase contrast movie loop with 22 ms true temporal resolution is acquired in one 10-heartbeat breathhold. Simulations indicate that this technique is capable of imaging through-plane jets with velocities up to 10 m/s, and initial studies in aortic stenosis patients show accurate in vivo measurement of peak velocities up to 4.2 m/s (using echocardiography as a reference).

Aortic Valve Stenosis↗

PubMed2003

Steady-state sequence synthesis and its application to efficient fat-suppressed imaging.

A new synthesis algorithm, based on the Shinnar-Le Roux (SLR) transform, can be used to generate fully refocused steady-state pulse sequences with arbitrary magnetization profiles as a function of off-resonant precession. This is accomplished by appropriate periodic oscillation of the RF excitation magnitude and phase from echo to echo. The technique is applied to the design of refocused steady-state free precession (SSFP) sequences with flat profiles, providing the opportunity for banding-artifact-free imaging with steady-state contrast. The algorithm is also used to generate refocused-SSFP sequences with an arbitrarily broad region of attenuated signal. These sequences are implemented and applied to the problem of steady-state fat suppression. Preliminary results show signal levels that agree well with theory, and a broad region of suppressed signal at each echo. Total imaging time is kept identical to that of a standard refocused-SSFP experiment through echo equalization and interleaving. 3D images from the leg of a normal volunteer acquired in 44 s demonstrate the applicability of the technique to fat-suppressed imaging.

Adipose Tissue↗

PubMed2003

Fast 3D imaging using variable-density spiral trajectories with applications to limb perfusion.

Variable-density k-space sampling using a stack-of-spirals trajectory is proposed for ultra fast 3D imaging. Since most of the energy of an image is concentrated near the k-space origin, a variable-density k-space sampling method can be used to reduce the sampling density in the outer portion of k-space. This significantly reduces scan time while introducing only minor aliasing artifacts from the low-energy, high-spatial-frequency components. A stack-of-spirals trajectory allows control over the density variations in both the k(x)-k(y) plane and the k(z) direction while fast k-space coverage is provided by spiral trajectories in the k(x)-k(y) plane. A variable-density stack-of-spirals trajectory consists of variable-density spirals in each k(x)-k(y) plane that are located in varying density in the k(z) direction. Phantom experiments demonstrate that reasonable image quality is preserved with approximately half the scan time. This technique was then applied to first-pass perfusion imaging of the lower extremities which demands very rapid volume coverage. Using a variable-density stack-of-spirals trajectory, 3D images were acquired at a temporal resolution of 2.8 sec over a large volume with a 2.5 x 2.5 x 8 mm(3) spatial resolution. These images were used to resolve the time-course of muscle intensity following contrast injection.

Contrast Media↗

PubMed2003

Magnetic resonance coronary angiography.

Magnetic resonance coronary angiography (MRCA) has witnessed tremendous technical advances over the past decade. Although high-quality images of the coronary arteries have been demonstrated, this imaging modality is not performed routinely today. The fundamental properties of the coronary arteries deterring noninvasive imaging are well known. This article provides an overview of the developmental efforts to overcome these challenges, and highlights key technical and clinical advances. The future prospect of MRCA depends on clinical implementation of the technique. In order to meet this challenge, the following issues must be addressed: contrast- and signal-to-noise ratio, temporal and spatial resolution, and scan protocol.

Coronary Angiography↗

PubMed2002

MR imaging of knee cartilage with FEMR.

OBJECTIVE: Fluctuating equilibrium magnetic resonance (FEMR) is a rapid three-dimensional (3D) imaging sequence with high signal-to-noise ratio (SNR). FEMR may be useful for detecting cartilage defects in the knee. At 1.5 T, FEMR uses a TR with odd multiples of 2.2 ms for fat/water separation. With a TR of 6.6 ms, high-resolution 3D imaging of cartilage is possible. DESIGN AND PATIENTS: The knees of 10 volunteers and two patients were imaged on a GE Signa 1.5 T scanner using an extremity coil. Scans were preceded by a shimming sequence optimizing linear terms. Subjects were imaged with FEMR, proton-density fast spin-echo (PD-FSE), T2-weighted fast spin-echo (T2-FSE), and 3D fat-suppressed spoiled-gradient-recalled echo (3D-SPGR). RESULTS: SNR and contrast-to-noise efficiency measurements for cartilage using FEMR were superior to those using PD-FSE, T2-FSE, and 3D-FS-SPGR. FSE images showed bright synovial fluid with limited cartilage detail. 3D-SPGR had comparable resolution to FEMR but suboptimal cartilage/fluid contrast and longer scan times (8 min versus 2 min). Cartilage surface detail, outlined by bright synovial fluid, was best seen on the FEMR images. DISCUSSION: FEMR obtains high-resolution 3D images of the entire knee in 2 min with excellent cartilage/fluid contrast. FEMR is sensitive to field inhomogeneity and requires shimming. Surface defects are outlined by bright synovial fluid, and cartilage has higher signal-to-noise efficiency compared with PD-FSE, T2-FSE, and 3D-SPGR techniques.

Cartilage, Articular↗

PubMed2002

Oscillating dual-equilibrium steady-state angiography.

A novel technique of generating noncontrast angiograms is presented. This method, called oscillating dual-equilibrium steady-state angiography (ODESSA), utilizes a modified steady-state free precession (SSFP) pulse sequence. The SSFP sequence is modified such that flowing material reaches a steady state which oscillates between two equilibrium values, while stationary material attains a single, nonoscillatory steady state. Subtraction of adjacent echoes results in large, uniform signal from all flowing spins and zero signal from stationary spins. Venous signal can be suppressed based on its reduced T2. ODESSA arterial signal is more than three times larger than that of traditional phase-contrast angiography (PCA) in the same scan time, and also compares favorably with other techniques of MR angiography (MRA). Pulse sequences are implemented in 2D, 3D, and volumetric-projection modes. Angiograms of the lower leg, generated in as few as 5 s, show high arterial signal-to-noise ratio (SNR) and full suppression of other tissues.

Artifacts↗

PubMed2002

Fast phase-contrast velocity measurement in the steady state.

A new method of encoding flow velocity as image phase in a refocused steady-state free precession (SSFP) sequence, called steady-state phase contrast (SSPC), can be used to generate velocity images rapidly while retaining high signal. Magnitude images with refocused-SSFP contrast are simultaneously acquired. This technique is compared with the standard method of RF-spoiled phase contrast (PC), and is found to have more than double the phase-signal to phase-noise ratio (PNR) when compared with standard PC at reasonable repetition intervals (TRs). As TR decreases, this advantage increases exponentially, facilitating rapid scans with high PNR efficiency. Rapid switching between the two necessary steady states can be accomplished by the insertion of a single TR interval with no flow-encoding gradient. The technique is implemented in a 2DFT sequence and validated in a phantom study. Preliminary results indicate that further TR reduction may be necessary for high-quality cardiac images; however, images in more stationary structures, such as the descending aorta and carotid bifurcation, exhibit good signal-to-noise ratio (SNR) and PNR. Comparisons with standard-PC images verify the PNR advantage predicted by theory.

Aorta, Thoracic↗

PubMed2002

In vivo real-time intravascular MRI.

PURPOSE: The Magnetic resonance imaging (MRI) is an emerging technology for catheter-based imaging and interventions. Real-time MRI is a promising methodfor overcoming catheter and physiologic motion for intravascular imaging. METHODS: All imaging was performed on a 1.5 T Signa MRI scanner with high-speed gradients. Multiple catheter coils were designed and constructed, including low-profile, stub-matched coils. Coil sensitivity patterns and SNR measurements were compared. Real-time imaging was performed with an interleaved spiral sequence using a dedicated workstation, providing real-time data acquisition, image reconstruction and interactive control and display. Real-time "black-blood" imaging was achieved through incorporation of off-slice saturation pulses. The imaging sequence was tested in a continuous flow phantom and then in vivo in the rabbit aorta using a 2 mm catheter coil. RESULTS: The real-time intravascular imaging sequence achieved 120-440 micron resolution at up to 16 frames per second. Low-profile stub-tuned catheter coils achieved similar SNR to larger traditional coil designs. In the phantom experiments, addition of real-time black-blood saturation pulses effectively suppressed the flow signal and allowed visualization of the phantom wall. In vivo experiments clearly showed real-time intravascular imaging of the rabbit aortic wall with minimal motion artifacts and effective blood signal suppression. CONCLUSIONS: Real-time imaging with low-profile coil designs provides significant enhancements to intravascular MRI.

Animals↗